Science suggests that emotion is anything but primitive and unpredictable. It’s a complex, exquisitely efficient information-processing system, designed to organize behavior rapidly in the interests of survival. It’s an internal signaling system, telling us about what matters in the flood of stimuli that bombard us and tuning us in to our own inner needs. Research with brain-damaged subjects shows that without emotion to guide us, we can’t make even the most elementary of decisions; we’re bereft of preferences and have nothing to move us toward one option rather than another.

Emotional signals, especially nonverbal, such as facial expression and tone of voice, communicate our intentions to others. Our brain takes just 100 milliseconds to detect and process the smallest change in a human face and just 300 milliseconds to mirror this change in our own body, so we literally “feel” another’s emotion. The fact that we can rapidly read intentions and coordinate actions has offered our species a huge advantage. The ability to read six basic emotional expressions and assign the same meaning to these expressions is universal.

There’s a consensus among experts that these basic emotions are anger, sadness, joy, surprise, shame, and fear. In anger, for example, the stare becomes fixed, eyes widen, and the brows contract; the lips compress and the body tenses. The impulse is to mobilize and move toward the object of the emotional response, so as to take control or eliminate the obstacle. When a client sits in front of me and tells me she has no idea how she feels, it helps me immeasurably to know that, in all probability, she’s feeling her own version of one of these six core emotions.

We have evidence that just naming emotions—literally putting feelings into words—seems to calm down amygdala activity in the brains of subjects viewing negative emotional images or faces. So it may help us “trust” emotion and see it as a positive tool in psychotherapy if we can keep in mind the elements that make up an emotional experience. First, there’s a cue from the environment. This is followed by an initial general perception (such as “bad”) and orientation to this cue and physical arousal. The meaning of cues and sensations is further evaluated in a more reflective cognitive appraisal. All these things prime a “move”—a compelling action tendency. These reactions all happen inside the skin, but they don’t stay there. Emotion isn’t silent or hidden. The signals that accompany this process create what psychologist and author Daniel Goleman calls a “neural duet” with others.

Not only do we have different levels of emotion, we have reflexive emotions—emotions about our emotions. Clients often have deep anxiety about the catastrophe that awaits if they stay with their primary softer emotions, like sadness or fear. The general list of negative expectations can be framed as responses to the open-ended sentence, “If I become open and vulnerable, I’ll find that I’m. . . .” The answers—which can be summarized as the 4 D’s—are: defective, disintegrating, drowning, or dismissed. This list seems to cut across gender, class, and culture.

Clients express these fears as follows: “If I feel my softer, deeper emotions, this means that I’m weak or inadequate; others will see me this way and reject me”; “If I feel this, I’ll become more and more distressed; I’ll lose myself”; “If I feel this, the emotion will never go away—it’ll go on forever, and I’ll drown in it”; “If I feel this, no one will respond or be there to save me.”

I used to see clients’ expression of this kind of pain as a metaphor, but it’s more than this. Emotions “are of the flesh, and they sear the flesh,” said Frijda. Until recently, the parallels between emotional pain, such as rejection, and physical pain, like burning your arm, were thought to be purely because of shared psychological distress. Now it’s clear that there’s a neural overlap in the way we process and experience social and physical pain. Tylenol can reduce hurt feelings, and social support can lessen physical pain. As predicted by Attachment Theory, emotional isolation and the helplessness associated with it seem to be key features of this emotional pain. Our need for connection with others has shaped our neural makeup and the structure of our emotional life.

Once we can name implicit core emotions, track them through our clients’ nonverbal communication, and thus create an integrated emotional experience by identifying all the elements and placing them in an attachment context, it isn’t difficult to work with clients who are usually inexpressive or unaware of their feelings. When clients can touch their core emotions, implicit cognitions about the self, others, and the nature of life emerge and become available for review.